The CMS recognizes the need for provider Customer Service Representative training.
The goal is to help CSRs improve the consistency and accuracy of their answers to provider questions, to increase their understanding of issues, and to facilitate CSRs’
retention of the facts of their training by increasing its frequency. To accomplish this goal, all Medicare Provider Contact Centers may close for up to 8 hours per month for CSR training and/or staff development with the following limitations:
• The 8 hours approved by CMS for contact center closure shall be used for training time only.
• The training time shall not be used for corporate meetings. Contractors shall request permission to close in those circumstances according to Section 20.1.A of this chapter.
• Training time not used within a specific month shall not be carried over to the next month.
Time used for training on Federal holidays is in addition to the 8 hours per month allowed by CMS for CSR training closure. This 8 hour allowance is separate from any training time occurring during Federal holidays in accordance with Section 20.1.A of this chapter.
1. Closure Determination
Contractors shall perform an analysis to evaluate the appropriate time for closure to anticipate the impact on their ability to meet all CMS performance requirements as instructed in Sections 20.1.3 and 20.2.1.4 of this chapter. Contractors should consult their POE Advisory Group about the best hours for training closures and training topics.
CMS will not view performance waivers favorably if the training time closures are the justification for poor performance.
2. Provider Complaints
Contractors shall monitor provider complaints about training time closures and take action to resolve them and decrease the volume of complaints. Reports about provider complaints and their resolution shall be kept on site and available to CMS upon request.
3. Training Schedule
Contractors shall submit to CMS a training schedule, including dates, times, topics, sub-topics and contact information by the 15th of the month prior to when the training will be performed via the Provider Services mailbox, [email protected] using the subject line “Training Schedule”. CMS will post training schedules and contact
information submitted by all Medicare contractors at
http://www.cms.hhs.gov/ContractorLearningResources/02_Training.asp#TopofPage.
Upon receipt of the training schedule, CMS will send an acknowledgement e-mail.
Contractors shall assume approval of closures of 4 hours or less unless they receive notification to the contrary.
4. Training Closures of More than Four Hours
For training of more than four hours on the same day, contractors shall request CMS approval at least a month in advance of the training date via the Provider Services mailbox, [email protected] using the subject line “One Time Approval Request”. CMS will provide one time authorization for training closure requests of more than four hours. CMS will evaluate this type of authorization on a case by case basis and authorize it under special circumstances within one week of receipt. If the contractor does not receive a confirmation from CMS within one week of submitting its request for training closure, the contractor can close for training under the assumption that its request was approved.
In instances where changes to previously approved training schedules are necessary, contractors shall submit all requests for changes via the Provider Services mailbox, [email protected] using the subject line “Change of One Time Approval”.
A new CMS approval is required to proceed with changes to previously approved
training schedules. Changes shall be submitted to CMS within a reasonable time, enough to allow provider notification.
5. Provider Notifications
Contractors shall notify providers about their closure time for training. At a minimum, contractors shall post a closure notification for providers on their IVRs and websites.
Contractors with separate lines for IVR and CSRs shall post a closure notification for providers on both lines. See additional instructions regarding IVR posting in Section 20.1.B of this chapter. In addition to the IVR and website, contractors shall use their listserv to notify providers of CMS authorized one time only-training closure or a training closure out of the contractor’s regular training schedule. Contractors shall use their listserv to notify their provider community of their closure times the first time that they implement the Training Program in their site.
Contractors shall notify providers of all training closures or changes in their training closure schedule at least two weeks in advance of the training date. For training of more than four hours approved by CMS, contractors shall notify providers at least three weeks in advance of training closure.
6. CSR Feedback
To assure that CSRs are receiving the maximum benefit of the training program, contractors should use CSRs’ feedback from training, CSRs’ pre-and post-training and retention results to determine improvement opportunities to their training program and for development of refresher training. Contractors should implement a process to
evaluate the CSRs’ progress pre- and post- training on a monthly basis. Also, contractors should implement a process to periodically evaluate the CSRs’ retention of training information.
7. Reports
a. Contractors shall report in CSAMS the following:
(1) the number of hours per month that the contractor closed for training, during normal business hours
(2) the number of hours used for training on Federal holidays.
b. Copies of CMS written approval, training schedule, training plan, training materials, as well as CSR attendance sheets, shall be made available upon request.
8. CMS Monitoring
For monitoring purposes, contractors’ telephone systems shall allow calls from CMS or CMS’s representatives to CSRs. These CMS callers will not have a provider number. CSRs shall respond to these calls as if they were calls from the provider community.
20.1.7 - Quality Call Monitoring (QCM)
(Rev.18, Issued: 09-08-06, Effective: 10-01-06, Implementation: 10-02-06)
Contractors shall have a monitoring program in place to ensure the quality of telephone inquiries responses. The monitoring program shall, at a minimum, follow the
requirements and performance standards as set forth in the QCM program. The
guidelines established apply to contractors’ general provider inquiry telephone numbers.
The standards shall not apply to those inquiries handled by other units within the contractor (e.g., appeals, fraud, MSP). As contractors are ultimately responsible for the quality of their responses to provider inquiries, contractors shall use the results of the QCM program to identify, and act upon, areas of needed improvement, both for the call center as a whole and for individual call center staff. Contractors shall document their monitoring efforts and corrective action plans as applicable, and provide such
information to CMS upon request.